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European Radiology
Published in: European Radiology 4/2018

01-04-2018 | Chest

Optimisation of window settings for traditional and noise-optimised virtual monoenergetic imaging in dual-energy computed tomography pulmonary angiography

Authors: Tommaso D’Angelo, Andreas M. Bucher, Lukas Lenga, Christophe T. Arendt, Julia L. Peterke, Damiano Caruso, Silvio Mazziotti, Alfredo Blandino, Giorgio Ascenti, Ahmed E. Othman, Simon S. Martin, Doris Leithner, Thomas J. Vogl, Julian L. Wichmann

Published in: European Radiology | Issue 4/2018

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Abstract

Objectives

To define optimal window settings for displaying virtual monoenergetic images (VMI) of dual-energy CT pulmonary angiography (DE-CTPA).

Methods

Forty-five patients who underwent clinically-indicated third-generation dual-source DE-CTPA were retrospectively evaluated. Standard linearly-blended (M_0.6), 70-keV traditional VMI (M70), and 40-keV noise-optimised VMI (M40+) reconstructions were analysed. For M70 and M40+ datasets, the subjectively best window setting (width and level, B-W/L) was independently determined by two observers and subsequently related with pulmonary artery attenuation to calculate separate optimised values (O-W/L) using linear regression. Subjective evaluation of image quality (IQ) between W/L settings were assessed by two additional readers. Repeated measures of variance were performed to compare W/L settings and IQ indices between M_0.6, M70, and M40+.

Results

B-W/L and O-W/L for M70 were 460/140 and 450/140, and were 1100/380 and 1070/380 for M40+, respectively, differing from standard DE-CTPA W/L settings (450/100). Highest subjective scores were observed for M40+ regarding vascular contrast, embolism demarcation, and overall IQ (all p<0.001).

Conclusions

Application of O-W/L settings is beneficial to optimise subjective IQ of VMI reconstructions of DE-CTPA. A width slightly less than two times the pulmonary trunk attenuation and a level approximately of overall pulmonary vessel attenuation are recommended.

Key Points

• Application of standard window settings for VMI results in inferior image perception.
• No significant differences between B-W/L and O-W/L for M70/M40+ were observed.
• O-W/L for M70 were 450/140 and were 1070/380 for M40+.
• Improved subjective IQ characteristics were observed for VMI displayed with O-W/L.
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Metadata
Title
Optimisation of window settings for traditional and noise-optimised virtual monoenergetic imaging in dual-energy computed tomography pulmonary angiography
Authors
Tommaso D’Angelo
Andreas M. Bucher
Lukas Lenga
Christophe T. Arendt
Julia L. Peterke
Damiano Caruso
Silvio Mazziotti
Alfredo Blandino
Giorgio Ascenti
Ahmed E. Othman
Simon S. Martin
Doris Leithner
Thomas J. Vogl
Julian L. Wichmann
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5059-6

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